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https://www.readbyqxmd.com/read/29305234/reproductive-outcomes-after-fertility-sparing-surgery-for-focal-and-diffuse-adenomyosis-a-systematic-review
#1
REVIEW
Justin Tan, Sophie Moriarty, Omur Taskin, Catherine Allaire, Christina Williams, Paul Yong, Mohamed A Bedaiwy
Among the variety of treatment options to improve reproductive outcomes for infertile women with adenomyosis (AD), uterine conserving surgery has demonstrated varying success. Hence, we conducted a systematic review around the topic of fertility-sparing surgery across 18 studies and 1396 infertile women with focal and diffuse AD. Patients with focal AD demonstrated mean pregnancy and miscarriage rates of 52.7% (range:14.3-77.5%) and 21.1% (range:0-44.4%), respectively, while patients with diffuse AD had a mean pregnancy and miscarriage rate of 34...
January 2, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29184740/can-friedberg-s-triad-solve-persistent-anesthesia-problems-over-medication-pain-management-postoperative-nausea-and-vomiting
#2
Barry L Friedberg
Friedberg's Triad is (1) measure the brain; (2) preempt the pain; (3) emetic drugs abstain. Persistent anesthesia problems include over- and under-medication, postoperative pain management, and postoperative nausea and vomiting. Inspired by Vinnik's diazepam-ketamine paradigm, Friedberg's propofol ketamine paradigm was first published in 1993. The 1997 addition of the bispectral (BIS) index brain monitor made the propofol ketamine paradigm numerically reproducible. The 1998 addition of the frontalis electromyogram (EMG) as a secondary trend to the BIS transformed the time-delayed BIS monitor into a real-time, extremely useful device...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29178601/the-prevalence-risk-factors-and-outcomes-of-medication-tradeoffs-in-kidney-and-liver-transplant-recipients-a-pilot-study
#3
Marina Serper, Peter Reese, Rachel Patzer, Josh Levitsky, Michael S Wolf
High out-of-pocket medication costs negatively impact adherence in transplantation. We evaluated the association of "medication tradeoffs" - defined as choosing to spend money on other expenses over medications -with medication non-adherence and transplant outcomes. From 2011-2012, we performed a prospective study of 201 transplant recipients (n=103 liver, n=98 kidney and) at two large US transplant centers. Structured interviews assessed socio-demographics, medication adherence, and medication tradeoffs. Multivariable models assessing risk factors for medications tradeoffs and the association between medications tradeoffs and post-transplant hospital admissions were performed...
November 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29145076/veterans-group-exercise-a-randomized-pilot-trial-of-an-integrative-exercise-program-for-veterans-with-posttraumatic-stress
#4
Lizabeth A Goldstein, Wolf E Mehling, Thomas J Metzler, Beth E Cohen, Deborah E Barnes, Gerard J Choucroun, Aliza Silver, Lisa S Talbot, Shira Maguen, Jennifer A Hlavin, Margaret A Chesney, Thomas C Neylan
BACKGROUND: Posttraumatic stress disorder (PTSD) is prevalent among military veterans and is associated with significant negative health outcomes. However, stigma and other barriers to care prevent many veterans from pursuing traditional mental health treatment. We developed a group-based Integrative Exercise (IE) program combining aerobic and resistance exercise, which is familiar to veterans, with mindfulness-based practices suited to veterans with PTSD. This study aimed to evaluate the effects of IE on PTSD symptom severity and quality of life, as well as assess the feasibility and acceptability of IE...
November 4, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29110789/long-term-management-of-end-stage-heart-failure
#5
REVIEW
Marlena V Habal, A Reshad Garan
End-stage heart failure manifests as severe and often relentless symptoms that define the clinical syndrome of heart failure, namely congestion and hypoperfusion. These patients suffer from dyspnea, fatigue, abdominal discomfort, and ultimately cardiac cachexia. Renal and hepatic dysfunction frequently further complicates the process. Recurrent hospitalizations, cardiac arrhythmias, and intolerance to standard heart failure therapies are common as the disease progresses. Management focuses on controlling symptoms, correcting precipitants, avoiding triggers, and maximizing therapies with demonstrable survival benefit...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29089184/patient-counselling-and-consent
#6
REVIEW
Akanksha Sood, Janesh Gupta
To the patient, illness entails not only the physical discomfort but all the psychological, social and emotional ramifications. Patient autonomy and choice are now an integral part of patient care pathways. There has been a steady shift in patient counselling and consent towards supporting patient autonomy over medical paternalism. Patients should be the prime decision makers but they can only do this if they are fully informed. The ultimate and desired goal for the health care teams is to provide a high quality clinical service, which is consistent with evidence based guidelines...
October 13, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29048408/the-charlie-gard-case-british-and-american-approaches-to-court-resolution-of-disputes-over-medical-decisions
#7
J J Paris, J Ahluwalia, B M Cummings, M P Moreland, D J Wilkinson
No abstract text is available yet for this article.
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28955382/atrial-fibrillation-in-heart-failure-a-therapeutic-challenge-of-our-times
#8
REVIEW
Syeda Atiqa Batul, Rakesh Gopinathannair
Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of "atrial kick" translates into poorer quality of life and increased mortality...
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28871026/study-protocol-for-a-matter-of-heart-a-qualitative-study-of-patient-factors-driving-overuse-of-cardiac-catheterisation
#9
Anna Herwig, Birgitta Weltermann
INTRODUCTION: Overuse of cardiac catheterisation (CC) for stable coronary artery disease (CAD) is documented in Germany and other regions, although percutaneous coronary interventions do not provide a benefit over medical therapy for stable patients. Various studies investigated health system, physician and patient factors driving non-adherence to guidelines which recommend a stepwise approach with invasive procedures only in case of signs of ischaemia in non-invasive testing. In a larger-scale project, we aim to better understand the patients' perspective in order to develop an intervention that enhances patient's acceptance of this stepwise diagnostic approach for stable CAD...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28863875/-hypothyroidism-in-adults-in-a-basic-health-area
#10
I López-Macías, A Hidalgo-Requena, E Pérez-Membrive, M E González-Rodríguez, C Bellido-Moyano, L A Pérula-de Torres
INTRODUCTION: The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). INCLUSION CRITERIA: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena...
August 29, 2017: Semergen
https://www.readbyqxmd.com/read/28839310/reproductive-health-issues-in-pakistan-do-myths-take-precedence-over-medical-evidence
#11
Khaula Atif, Syeda Sarwat Naqvi, Syed Abid Hassan Naqvi, Karishma Ehsan, Saleem Asif Niazi, Annam Javed
OBJECTIVE: To analyse the prevalence of myths pertinent to healthcare issues of females of reproductive age. METHODS: This cross-sectional, simple descriptive, knowledge, attitude and practices-education research was conducted at the Combined Military Hospital, Peshawar, Pakistan, from February to August 2016. A 30-item self-designed questionnaire was applied, collecting demographic details and answers to 21 close-ended questions encompassing the prevalence of myths pertinent to reproductive health issues of women in Pakistan...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28834793/surgical-ventricular-remodeling-should-we-stich-or-not
#12
Vivek Rao
PURPOSE OF REVIEW: The surgical management of patients with ischemic cardiomyopathy, especially those with left ventricular ejection fractions less than 20% has historically been controversial. The original trials of surgical revascularization versus medical therapy intentionally excluded those patients with an ejection fraction less than 35%. The significant advances in medical therapy for heart failure over the past 30 years (β-blockade, angiotensin converting enzyme inhibitors, internal cardiac defibrillator and so on) also mandated a reevaluation of the potential benefits of surgical revascularization in this high-risk subset...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28802465/integrative-medicine-for-geriatric-and-palliative-care
#13
REVIEW
Mikhail Kogan, Stephanie Cheng, Seema Rao, Sharon DeMocker, Mariatu Koroma Nelson
More than 80% of people in the United States who are older than 65 years have 1 or more chronic medical problems, and 50% have 2 or more. The cost of care for the elderly is at least 3 to 4 times that of younger populations and is rapidly growing, mostly because of a lack of preventive approaches and overly medicalized and fragmented care. This article summarizes the most up-to-date evidence for specific integrative modalities for common geriatric conditions, including falls, frailty, osteoporosis, and end-of-life palliative care...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28768943/what-the-desirable-collaboration-between-care-workers-in-nursing-homes-and-phamacists-should-be-an-approach-for-security-and-safe-medication-for-residents-in-nursing-homes
#14
Hideyuki Maki, Akira Shiraishi, Akiko Miki, Hiroki Satoh, Yukari Konishi, Kohei Asai, Kenichi Funahashi, Yoshinobu Usui, Yasufumi Sawada
In our previous research, there was no collaboration between care workers and pharmacists, for the most part. As a result, it was discovered that in some cases, problems concerning medication of nursing home residents had not been resolved. To solve this issue, we brought together care workers and pharmacists for a workshop we conducted. We assigned 12 care workers with at least two years of experience and 12 pharmacists to four mixed groups and guided them in the management of in-home long-term medical care and conducted small group discussions (SGD) using the KJ method...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28739097/surgery-for-diabetes-clinical-and-mechanistic-aspects
#15
REVIEW
Jordanna Kapeluto, André Tchernof, Laurent Biertho
According to the most recent publication by the Canadian Public Health Agency, obesity affects 25% of adults. In addition, there is a clear association between the recent rise in obesity and the increased prevalence of type 2 diabetes. Medical therapy for obesity has shown limited long-term effectiveness, and surgical treatment is now recognized by medical authorities as part of the armamentarium for the management of type 2 diabetes in severely obese patients. The current indications for obesity surgery and postoperative management are reviewed...
August 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28716335/management-of-chronic-total-coronary-occlusion-in-stable-ischemic-heart-disease-by-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-versus-medical-therapy
#16
MULTICENTER STUDY
Mony Shuvy, Feng Qiu, Alyssandra Chee-A-Tow, John J Graham, Wael Abuzeid, Christopher Buller, Bradley H Strauss, Harindra C Wijeysundera
Coronary chronic total occlusions (CTOs) are found in approximately 20% of angiograms. We sought to assess the variation in the management of patients with CTOs and to compare the clinical outcomes of CTO lesions with those of non-CTO lesions. We conducted a population-based cohort study and included all patients with stable angina who underwent cardiac catheterization from October 1, 2012, to June 30, 2013, in Ontario, Canada. The primary outcome was a composite of mortality and hospitalization for myocardial infarction...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28649928/beyond-the-medical-model
#17
Scott J Fitzpatrick, Jo River
The medical model continues to dominate research and shape policy and service responses to suicide. In this work we challenge the assumption that the medical model always provides the most effective and appropriate care for persons who are suicidal. In particular, we point to service user perspectives of health services which show that interventions are often experienced as discriminatory, culturally inappropriate, and incongruent with the needs and values of persons who are suicidal. We then examine "humanistic" approaches to care that have been proposed as a corrective to an overly medical model...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28611885/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adult-psychiatric-patients-part-ii-controversies-over-medical-assessment-and-consensus-recommendations
#18
REVIEW
Michael P Wilson, Kimberly Nordstrom, Eric L Anderson, Anthony T Ng, Leslie S Zun, Jennifer M Peltzer-Jones, Michael H Allen
INTRODUCTION: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. METHODS: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28498154/pediatric-to-adult-transition-and-medication-adherence-in-patients-with-inflammatory-bowel-disease
#19
Jayson Jeganathan, Cheng Hiang Lee, Antony Rahme, Darren K Tiao, Celine Weston, Shoma Dutt, Annabel Magoffin, Vu Kwan, Aladdin Alswaifi, Peter H Katelaris, Kevin J Gaskin, Edward V OʼLoughlin, Rupert W Leong
BACKGROUND: Medication nonadherence is common in inflammatory bowel disease and is associated with poor outcomes. There has been no study on pediatric-to-adult transition as a risk factor for nonadherence in inflammatory bowel disease, which has been demonstrated in other diseases. We aimed to assess whether transitioned (TR) patients have higher nonadherence rates than young adults (YAs) diagnosed in adulthood. METHODS: Consecutive ambulatory subjects were prospectively recruited and completed the validated Medication Adherence Reporting Scale (MARS), with the primary outcome being adherence differences between group age-matched TR and YA groups...
July 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28471282/cost-comparison-of-two-trabecular-micro-bypass-stents-versus-selective-laser-trabeculoplasty-or-medications-only-for-intraocular-pressure-control-for-patients-with-open-angle-glaucoma
#20
John P Berdahl, Anup K Khatana, L Jay Katz, Leon Herndon, Andrew J Layton, Tiffany M Yu, Matthew J Bauer, Louis B Cantor
AIM: Patients with open-angle glaucoma (OAG) whose intraocular pressure is not adequately controlled by one medication have several treatment options in the US. This analysis evaluated direct costs of unilateral eye treatment with two trabecular micro-bypass stents (two iStents) compared to selective laser trabeculoplasty (SLT) or medications only. MATERIALS AND METHODS: A population-based, annual state-transition, probabilistic, cost-of-care model was used to assess OAG-related costs over 5 years...
July 2017: Journal of Medical Economics
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